BACKGROUND: The choice of cardiac resynchronization therapy device, with (CRT-D) or without (CRT-P) a defibrillator, in patients with heart failure largely depends on the physician׳s discretion, because it has not been established which subjects benefit most from a defibrillator. METHODS: We examined the annual trend of CRT device implantations between 2006 and 2014, and evaluated the factors related to the device selection (CRT-D or CRT-P) for primary prevention of sudden cardiac death in patients with heart failure by analyzing the Japan Cardiac Device Treatment Registry (JCDTR) database from January 2011 and August 2015 (CRT-D, n=2714; CRT-P, n=555)...

BACKGROUND: This study assessed the role of surgical ablation for atrial fibrillation (AF) in decreasing tricuspid regurgitation (TR) and right-sided heart remodeling in patients after mitral valve procedure. METHODS AND RESULTS: Between 1994 and 2014, 1568 consecutive patients with AF undergoing mitral valve procedure were identified. In 26.0% (n=408), surgical ablation of AF was used. Propensity-score matching (PSM) was performed on the basis of 41 known perioperative risk variables...

BACKGROUND Atrial fibrillation (AF) and renal dysfunction are two common comorbidities in patients with chronic heart failure with reduced ejection fraction (HFrEF). This study evaluated the effect of permanent AF on renal function in HFrEF and investigated the associations of atrial fibrillation, neutrophil gelatinase-associated lipocalin (NGAL), and neutrophil-to-lymphocyte ratio (NLR) with adverse clinical outcome. MATERIAL AND METHODS Serum NGAL levels measured by ELISA and NLR were compared between patients with sinus rhythm (HFrEF-SR, n=68), with permanent AF (HFrEF-AF, n=62), and a healthy control group (n=50)...

PURPOSE: Smoking and alcohol addictions are common and worldwide. In the present study, we aimed to investigate the effects of these addictions on cardiac rhythm using heart rate variability (HRV) analysis. METHODS: Addicts (n=42 men: 22 cigarette; 20 cigarette and alcohol) and age-matched controls (n=34 men) were included in the study. All patients fulfill the criteria for dependence according to DSM-IV-TR. Electrocardiography (ECG) recordings were obtained for a total of 30 minutes...

PURPOSE: Foot bathing therapy is a simple technique that induces sensations of comfort and relaxation. The aim of this study was to examine the effect of foot bathing therapy on heart rate variability (HRV) parameters in a healthy population. METHODS: Participants were twenty healthy female subjects (median age=20.67 years, SD=1.04). The recording ECG was applied for 5 minutes before and for 5 minutes after foot bathing therapy of 10 minutes. Subjects rested for 10 minutes without recording ECG in order to stabilize autonomic parameters...

Electronic pacemakers have been used in patients with heart rhythm disorders for device-supported pacing. While effective, there are such shortcomings as limited battery life, permanent implantation of catheters, the lack of autonomic neurohumoral responses, and risks of lead dislodging. Here we describe protocols for establishing porcine models of sick sinus syndrome and complete heart block, and the generation of bioartificial pacemaker by delivering a strategically engineered form of hyperpolarization-activated cyclic nucleotide-gated pacemaker channel protein via somatic gene transfer to convert atrial or ventricular muscle cardiomyocytes into nodal-like cells that rhythmically fire action potentials...

Atrial fibrillation (AF) is the most prevalent arrhythmia leading to hospital admissions in the United States. The majority of patients with AF report symptoms associated with this condition that can lead to a decrease in health related quality of life (HRQOL) and functional status. Therefore, along with reducing the risk of stroke and mortality, improvements in such symptoms are important therapeutic goals in the management of patients with AF. Our current understanding of how AF and symptoms are linked is hampered by the dominant assessment paradigm, where symptoms thought to be associated with AF are measured at a single point in time (frequently at a clinic visit)...

RESEARCH OBJECTIVE: Assessment of sinoatrial node function after Maze III procedure combined with a mitral valve operation. METHODS: 100 patients were included in the research with persistent and long-standing persistent forms of atrial fibrillation (AF) and need of operative treatment concerning valve disease. The following preoperative preparation methods were executed to all patients: Electrocardiogram in 12 standard assignments;Two-dimensional echocardiographic with assessment of systolic and diastolic functions of the left ventricle, size of the left atrium and grade of valve disease;Transesophageal echocardiography for exclusion of blood clots in the left atrium and left atrial appendage;Coronary angiography for exclusion of coronary heart disease;Computer tomography for examination of cardiac chambers and anatomic characteristics of pulmonary veins...

Introduction Cryoballoon ablation (CB) has proven effective to treatment of patients (pts) with atrial fibrillation (AF). However, the isolated efficacy of CB to treat pts with long-standing persistent atrial fibrillation (LSPAF) is less know. We analyzed the acute results and the long-term follow-up of our pts suffering LSPAF and initially treated with CB. Methods A cohort of 44 pts, 37 male (84%) mean age (60±10 year) suffering LSPAF were treated with first (CB1): 15pts, and second (CB2): 29 pts, generation CB...

The underlying pathophysiology of supraventricular and ventricular arrhythmias remains a matter of intense investigation. Though evolving, the contemporary explanations do not encompass all aspects of arrhythmogenicity. An improved understanding of arrhythmia substrate is needed to augment therapeutic capabilities. Our observation and literature sources demonstrate relatively high incidence of transitory arrhythmias which are non-intentionally generated by the endocardial lead/catheter manipulation. These findings are interesting and potentially may crystallize the reflex-dependent proarrhythmic cardiac activity...

BACKGROUND: Cerebrovascular disease confers a major healthcare burden worldwide and is a major cause of death and disability. Several well-established risk factors, such as atrial fibrillation (AF), are associated with cerebrovascular disease and antithrombotic therapy reduces risk. DESIGN: This study was a subgroup analysis from the Belgian Heart Rhythm Week, a nationwide AF awareness programme. METHODS: We studied subjects screened between 2012 and 2014 with available data on clinical risk factors and antithrombotic treatment...

A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular node block, Mobitz Type 2, a shortened QT interval, downsloping ST depression and presence of U waves...

BACKGROUND: -For patients with in-hospital cardiac arrests due to non-shockable rhythms, delays in epinephrine administration beyond 5 minutes is associated with worse survival. However, the extent of hospital variation in delayed epinephrine administration and its impact on hospital-level outcomes is unknown. METHODS: -Within Get with the Guidelines-Resuscitation, we identified 103,932 adult patients (≥18 years) at 548 hospitals with an in-hospital cardiac arrest due to a non-shockable rhythm who received at least 1 dose of epinephrine between 2000 to 2014...

BACKGROUND: With the use of intensive insulin therapy and insulin secretagogues to optimize glycemic control in diabetes, hypoglycemia continues to present a clinical challenge. Hypoglycemia has been implicated in nocturnal sudden death in type 1 diabetes, and the mechanism underlying this is postulated to be cardiac arrhythmia. OBJECTIVE: This article reviews the evidence surrounding hypoglycemia and cardiac arrhythmia. METHODS: A structured search of the Pubmed bibliographic database was undertaken, and relevant peer-reviewed articles on the topic were included in the review...

OBJECTIVE: Thrombin is implicated in the genesis of arrhythmias and activation of thrombin receptors exacerbated ventricular arrhythmias following coronary artery ligation. The present study was designed to investigate the possible protective effect of the protease-activated receptor-1 antagonist, SCH79797 against ischemia and reperfusion arrhythmias in the rat heart. MATERIALS AND METHODS: Healthy male Wistar rats (250-350 g) were anesthetized with urethane. Coronary artery ligation was performed for 5 minutes followed by 10 minutes reperfusion...